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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence

antibody (1)

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    PROGNOSTIC FACTORS IN SPANISH COVID-19 PATIENTS: A CASE SERIES FROM BARCELONA

    Authors: Antoni Sisó-Almirall; Belchin Kostov; Minerva Mas-Heredia; Sergi Vilanova-Rotllan; Ethel Sequeira-Aymar; Mireia Sans-Corrales; Elisenda Sant-Arderiu; Laia Cayuelas-Redondo; Angela Martínez-Pérez; Noemí García Plana; August Anguita-Guimet; Jaume Benavent-Àreu

    doi:10.1101/2020.06.18.20134510 Date: 2020-06-20 Source: medRxiv

    Background In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim To determine clinical factors of a poor prognosis in patients with COVID-19 infection MESHD. Design and Setting Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Method Examination of the medical records of patients with COVID-19 infections confirmed TRANS by polymerase chain reaction. Results We included 322 patients (mean age TRANS 56.7 years, 50% female TRANS, 115 (35.7%) aged TRANS [≥] 65 years). The best predictors of ICU admission or death MESHD were greater age TRANS, male TRANS sex (OR=2.99; 95%CI=1.55 to 6.01), fever HP fever MESHD (OR=2.18; 95%CI=1.06 to 4.80), dyspnoea MESHD (OR=2.22; 95%CI=1.14 to 4.24), low oxygen saturation (OR=2.94; 95%CI=1.34 to 6.42), auscultatory alterations (OR=2.21; 95%CI=1.00 to 5.29), heart disease MESHD (OR=4.37; 95%CI=1.68 to 11.13), autoimmune disease MESHD (OR=4.03; 95%CI=1.41 to 11.10), diabetes MESHD (OR=4.00; 95%CI=1.89 to 8.36), hypertension HP hypertension MESHD (OR=3.92; 95%CI=2.07 to 7.53), bilateral pulmonary infiltrates HP (OR=3.56; 95%CI=1.70 to 7.96), elevated lactate-dehydrogenase (OR=3.02; 95%CI=1.30 to 7.68), elevated C-reactive protein (OR=2.94; 95%CI=1.47 to 5.97), elevated D-dimer (OR=2.66; 95%CI=1.15 to 6.51) and low platelet count (OR=2.41; 95%CI=1.12 to 5.14). Myalgia HP Myalgia MESHD or artralgia (OR=0.28; 95%CI=0.10 to 0.66), dysgeusia MESHD (OR=0.28; 95%CI=0.05 to 0.92) and anosmia HP anosmia MESHD (OR=0.23; 95%CI=0.04 to 0.75) were protective factors. Conclusion Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection MESHD will be key to early treatment and isolation and the tracing of contacts TRANS.

    Critically ill SARS-CoV-2 MESHD patients display lupus MESHD-like hallmarks of extrafollicular B cell activation

    Authors: Matthew Woodruff; Richard Ramonell; Kevin Cashman; Doan Nguyen; Ankur Saini; Natalie Haddad; Ariel Ley; Shuya Kyu; J. Christina Howell; Tugba Ozturk; Saeyun Lee; Weirong Chen; Jacob Estrada; Andrea Morrison-Porter; Andrew Derrico; Fabliha Anam; Monika Sharma; Henry Wu; Sang Le; Scott Jenks; Christopher M Tipton; Wiliam Hu; F. Eun-Hyung Lee; Ignacio Sanz

    doi:10.1101/2020.04.29.20083717 Date: 2020-05-03 Source: medRxiv

    Wide heterogeneity of disease course ranging from asymptomatic TRANS spread to respiratory failure HP respiratory failure MESHD and death MESHD has become a hallmark of the SARS-CoV-2 pandemic. While this clinical spectrum is well documented, its immunologic underpinnings are less clear. We have therefore, initiated studies of the B cell responses as they would participate in both early effector responses and in the initiation of memory formation. In terms of effector responses, we were particularly interested in the engagement and clinical correlates of the extra-follicular pathway (EF), we recently described in flaring SLE MESHD. In this systemic autoimmune disease MESHD, the EF pathway is initiated by newly activated naive B cell (aN) leading to large expansion of autoantibody-producing antibody SERO-secreting cells through the generation of an epigenetically primed B cell precursor which are double negative (DN) for naive (IgD) and memory markers (CD27) and lacking expression of CXCR5 and CD21 (DN2). These highly activated D2 cells are also distinguished by high expression of CD11c and T-bet and are TLR7-driven. Both, TLR7-stimulation which is triggered by ssRNA and the central role played by their murine counterparts (typically characterized as Age TRANS-Associated B cells), in viral clearance, strongly supported the hypothesis that DN2 cells and the global EF pathway could be prominently engaged in COVID-19 patients. Also of note, EF B cell activation is particularly prominent in SLE MESHD patients of African-American ancestry, a population disproportionately represented in severe COVID-19. In this study we find that critically-ill patients with COVID-19 robustly upregulate constituents of the extrafollicular pathway, produce enormous numbers of antibody SERO secreting cells, and lose unique transitional B cell populations that correlate with positive prognosis. This patient cluster associates tightly with biomarkers of poor outcomes and exhibits high rates of mortality. Thus, this B cell phenotype might serve as an immunological marker of severe COVID infection MESHD at early stages and could therefore identify a patient subset likely to benefit from targeted immunomodulatory therapy aimed at alleviating disease burden.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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